Shiffman Saul, Ferguson Stuart G
Pinney Associates, Pittsburgh, PA 15213, USA.
Addiction. 2008 Apr;103(4):557-63. doi: 10.1111/j.1360-0443.2008.02138.x.
To evaluate the incremental efficacy of starting nicotine patch treatment prior to quitting compared to the current regimen of starting patch treatment on the target quit day.
Meta-analysis of four eligible studies using pre-cessation patch treatment, located by database search and contacts with cessation researchers. The studies all compared starting treatment with nicotine patch prior to the target quit date to starting active treatment at the quit date, some in the context of concurrent mecamylamine treatment. The primary end-point for the analysis was continuous abstinence for at least 28 days assessed at 6 weeks following quit day; 6-month outcomes were also examined.
Compared to starting active patch treatment on quit day, pre-cessation treatment with nicotine patches was found to double the odds of quitting. This was true both at 6 weeks [pooled odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.31-2.93] and 6 months (pooled OR = 2.17, 95% CI: 1.46-3.22) treatment outcomes. Mecamylamine co-treatment did not modify these effects.
Across the four studies analyzed, pre-cessation patch treatment was found to produce a robust increase in quit rates compared to current regimens starting patch at quit day. Pre-cessation patch use represents a promising innovation in smoking cessation therapy with potential beneficial implications for improved public health by further increasing quitting success.
评估在戒烟前开始尼古丁贴片治疗相较于目前在目标戒烟日开始贴片治疗方案的增效作用。
通过数据库检索及与戒烟研究人员联系，对四项使用戒烟前贴片治疗的符合条件的研究进行荟萃分析。这些研究均比较了在目标戒烟日期前开始使用尼古丁贴片治疗与在戒烟日开始积极治疗的效果，部分研究是在同时使用美加明治疗的背景下进行的。分析的主要终点是在戒烟日六周后评估的至少连续28天的持续戒烟情况；还对6个月的结果进行了检查。
与在戒烟日开始积极使用贴片治疗相比，发现戒烟前使用尼古丁贴片治疗使戒烟几率翻倍。在6周时（合并优势比[OR]=1.96，95%置信区间[CI]：1.31 - 2.93）和6个月时（合并OR = 2.17，95% CI：1.46 - 3.22）的治疗结果均如此。美加明联合治疗并未改变这些效果。
在所分析的四项研究中，发现与目前在戒烟日开始贴片治疗的方案相比，戒烟前贴片治疗能显著提高戒烟率。戒烟前使用贴片代表了戒烟治疗中一项有前景的创新，可能通过进一步提高戒烟成功率对改善公众健康产生有益影响。
